Of more than 900 health care corporations that ﬁled for bankruptcy in the U.S. between 2016 and the ﬁrst half of this year, nearly a ﬁfth were ﬁled in Texas courts, according to data from Bankruptcydata.com, which has tracked distressed companies since the 1980s. Founder George Putnam III predicts that the brisk rates will continue for a few more years. Adeptus Health and Walnut Hill Medical Center made recent headlines in North Texas given their sudden failures after promising starts. Here's a closer look at the Texas landscape.

"Texas deﬁnitely gets a disproportionate share of bankruptcies, but that is not to say things are more distressed than other states. The raw numbers can be misleading because one big ﬁling can lead to a spike. Texas is also an extremely active jurisdiction because the judges are high quality and it's a favorable venue for debtors that are trying to reorganize." — Jeremy Johnson, bankruptcy restructuring attorney for Polsinelli

Filing out

A total of 238 health care bankruptcies were ﬁled in Texas during the time period evaluated. However, they were not all individual cases. Over 100 of those ﬁled in North Texas were from private companies afﬁliated with Adeptus Health, the nation's largest freestanding emergency room operator. More than a dozen in South Texas were from afﬁliates of Uplift Rx,
a Houston pharmacy group.
When a corporation ﬁles for bankruptcy, it must estimate its debts or liabilities. Here are some of the health care businesses that had the biggest liabilities in each of the state's court districts between January 2016 and early June.

"If you're in an investment fund and you're looking at where to put money, health care looks like a good place. It's huge and growing, and the demographics suggest it will continue to do so. But it's also a heavily regulated industry, and regulated in a way that controls proﬁts. So it can be really difﬁcult to do a business plan." — Samuel Maizel, partner in Dentons' restructuring, insolvency and bankruptcy group

Private eye

Most of the bankruptcies were Chapter 11, which means the company negotiates its debt with its creditors. In Chapter 7, all of the company's assets are sold to pay the debts. Most of the Texas ﬁlings were from privately held companies, which are not required to publicly share quarterly earnings with the U.S. Securities and Exchange Commission.

"Bankruptcy ﬁlings are one proxy for looking at an industry's distress. But the true gauge goes beyond Chapter 11, as not every company in distress actually ﬁles. Many predict that the uncertainty created by the ongoing debate over the Affordable Care Act will continue to generate substantial ﬁnancial woes for the health care sector." — Sabriya Rice, health care reporter, The Dallas Morning News